Linking Housing and Health Data to Improve Residents’ Well-being

DASH Project Spotlight: King County Data Across Sectors for Housing and Health

Lead agency: Public Health – Seattle & King CountyPartners/collaborators: King County Accountable Community of Health, King County Housing Authority, Seattle Housing Authority

The challenge

As one of the fastest growing cities in the nation, Seattle has seen rental prices increase by 41% in the past five years. This demand has left many low-income residents with fewer options for safe, low-cost housing. To fill the gap, public housing authorities in Seattle and King County are providing affordable homes for 57,000+ low-income residents.

The increasingly cost-burdened housing market is one factor that has contributed to persistent health inequities in Seattle and King County, with low-income public housing residents disproportionately experiencing chronic illnesses, injuries, and mental health issues. These health disparities highlight the need for novel approaches that bring the public health and housing sectors together. By sharing data, these two sectors will be able to work together to identify pressing health needs of the residents, implement targeted interventions, and evaluate their effectiveness.

The opportunity

Through Data Across Sectors for Health (DASH), Public Health – Seattle & King County is partnering with the King County Housing Authority and the Seattle Housing Authority to develop an integrated data system that will establish regular and bi-directional exchange of health and housing data. The project is part of the King County Accountable Community of Health, a multi-sector partnership working to improve the health and well-being of county residents.

Because the majority of public housing residents are insured through Medicaid, claims data was selected as the data set to analyze the population’s health conditions. This data will be linked to public housing authority administrative data so that the public health and housing agencies can identify prevalent chronic conditions and analyze health care utilization trends among public housing residents. The data will provide insights into what programming or outreach might be most valuable for residents, and can be used to evaluate the inputs and costs associated with these initiatives. Project Director Amy Laurent commented:

“We know safe and affordable housing is a key component to health, and we want to build on that evidence base to understand how housing stability impacts physical and mental health and the potential return on investments both housing and preventive health services can make.”

Public Health – Seattle & King County will take the extracts of resident data provided by the housing authorities, link it to Medicaid claims data, and return a de-identified dataset to the housing authorities which will be used for planning and evaluation purposes. Providing housing authorities with direct access to the dataset will allow them to conduct internal analyses driven by the specific needs of their communities. Laurent noted:

“The goal is to empower our housing authorities to be able to make decisions about what interventions they may want to implement in a particular area. For example, if they find that there’s a group of residents that has a high level of diabetes, they might want to offer diabetes prevention and control classes or have community health workers provide education in that area. Then, they can use the data to see whether the program is actually making a difference in the number of people who end up in the emergency room for uncontrolled blood sugar.”

Engaging sectors to work together

Before embarking on their DASH project, Public Health – Seattle & King County had a long history of effective collaboration with public housing authorities. In 2010, data on the impact of exposure to secondhand smoke among families in subsidized housing motivated a partnership to implement a smoke-free housing policy for all public housing units. After the policy was implemented, there was a drop in the number of low-income smokers. However, lacking linked data, they were unable to analyze change in exposure to second-hand smoke in the different public housing authority buildings.

After successfully working in partnership over many years on various initiatives, from asthma prevention to outreach led by community health workers, it became clear to the public health and public housing authorities that sharing data was a natural next step that could help them achieve a greater collective impact towards their shared goals. Laurent explained:

“When people have the opportunity to get involved in projects where they’re really passionate and can see how data-driven planning and evaluation allows for more effective decision-making, then they really start to understand the power of data. Harnessing that can be a very valuable tool.”

The Seattle and King County housing authorities are designated by the U.S. Department of Housing and Urban Development (HUD) as Moving to Work agencies, meaning that they have funding to design and test innovative local strategies that assist their residents in becoming self-sufficient. Since health is a determinant of many indicators of self-reliance, the integration of resident data with health data will enable housing authorities analyze the return on investment of various initiatives and accomplish their Moving to Work goals. Laurent commented:

“When we started talking about this project and the relationship between health and housing, [the public housing authorities] became very active and interested partners. Some of the legwork had already been set because of the successful collaborations we had in the past, in addition to them having these additional resources and funding from HUD.”

Looking to the future

Linking Medicaid claims and public housing data will result in a closer alignment of housing and health, ultimately improving the health of low-income residents while reducing medical costs. These are primary aims of the King County Accountable Community of Health, which has served as a backbone for the collaboration and helped bring non-traditional partners to the table.

The project team is exploring opportunities to potentially expand the integrated data system to incorporate other local nonprofit and private affordable housing data sets, as well as data from other sectors like behavioral health and education. Laurent explained:

“The goal was never just to stop with health and housing data, but to try to build it out as much as we can to really have a robust picture of health—not just physical health, but also behavioral health—so that we can see the impacts of various programs.”

As the integrated data system continues to grow, more powerful analyses can illuminate issues driving health inequities in King County and generate lessons learned for other local health jurisdictions, public housing authorities, and the broader group of stakeholders invested in the Accountable Communities of Health. With a recognition that housing matters to health, now is the opportune time to link data across sectors to create healthier homes and communities.

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